Super-oxidized solution (Dermacyn Wound Care) as adjuvant treatment in the postoperative management of complicated diabetic foot osteomyelitis: preliminary experience in a specialized department

• Published in: International journal of lower extremity wounds Vol. 12; no. 2; p. 130
• Main Authors: Aragón-Sánchez, Javier, Lázaro-Martínez, Jose Luis, Quintana-Marrero, Yurena, Sanz-Corbalán, Irene, Hernández-Herrero, Maria J, Cabrera-Galván, Juan J
• Format: Journal Article
• Language: English
• Published: United States 01.06.2013
• Subjects: Aged; Anti-Infective Agents, Local - pharmacology; Anti-Infective Agents, Local - therapeutic use; Debridement; Diabetic Foot - microbiology; Diabetic Foot - surgery; Drug Combinations; Female; Humans; Hypochlorous Acid - pharmacology; Hypochlorous Acid - therapeutic use; Limb Salvage; Male; Middle Aged; Osteomyelitis - drug therapy; Osteomyelitis - pathology; Osteomyelitis - surgery; Postoperative Care; Recurrence; Sodium Hypochlorite - pharmacology; Sodium Hypochlorite - therapeutic use; Wound Healing - drug effects; diabetic foot infections; osteomyelitis; diabetic foot; super-oxidized solution
• ISSN: 1552-6941
• DOI: 10.1177/1534734613476710

Surgery is usually used to treat diabetic foot osteomyelitis (DFO), whether primarily or in cases in which antibiotics are not able to control infection. In many cases, the bone is only partially removed, which means that residual infection remains in the bone margins, and the wound is left open to heal by secondary intent. The use of culture-guided postoperative antibiotic treatment and adequate management of the wound must be addressed. No trials exist dealing with local treatment in the postoperative management of these cases of complicated DFO. We decided to test a super-oxidized solution, Dermacyn Wound Care (DWC; Oculus Innovative Sciences Netherlands BV, Sittard, Netherlands) to obtain preliminary experience in patients in whom infected bone remained in the surgical wounds. Our hypothesis was that DWC could be useful to control infection in the residual infected bone and surrounding soft tissues and would thus facilitate healing. Fourteen consecutive patients who underwent conservative surgery for DFO, in whom clean bone margins could not be assured, were treated in the postoperative period with DWC. Eleven cases were located in the forefoot, 6 on the first ray and the rest in lesser toes, 1 in the Lisfranc joint, and 2 on the calcaneus. No side effects appeared during treatment. Neither allergies nor skin dermatitis were found. Limb salvage was successfully achieved in 100% of the cases. Healing was achieved in a median period of 6.8 weeks.